Marathon training with hormonal imbalances

Q: I just finished my fifth marathon last Sunday and my time was horrible. I’m a 41-year old female with a career and two beautiful active boys. I had breast cancer almost fifteen years ago and had chemotherapy and a mastectomy.I am very active competing in triathlons and running events. I decided to have the Cancer Gene Test two years ago and unfortunately it came back positive with the BARCA 2 gene. I did prophylactic surgery and had my ovaries removed. I went on a really light dose of hormone therapy. I ran Chicago Marathon last October, it wasn’t my best time compared to my two LA marathons and Long Beach Marathon before the surgery. I was encouraged by my Oncologist and other doctors to get off the hormonal replacement, I did right after the Chicago Marathon and it threw me into surgical menopause. I trained so hard for this marathon, not only running hills, but cross training, squats, weights, box jumps, and spinning. I’m trying to qualify for the Boston Marathon. Up until mile fifteen I felt fine.By mile 17 and 19, I felt like I was going to faint and was extremely sore, but I pushed through to complete the marathon. Do you think having no estrogen has an effect on marathon performance?Thank you -

A: Hi, Holly. I’m glad you wrote and thank you for sharing your story. You’re an inspiration. Although there are a lot of things that are out of your control, there are just as many strategies you can employ to get back on track. As women progress in life, they lose their estrogen. Therefore, a shift in how we eat, exercise and live needs to happen to re-balance our energy and hormones. Yours was less shifting and more buttons activated, but nonetheless these actions will help you perform at your best.

The symptoms you’re experiencing are likely due to the loss of both estrogen and progesterone from the bilateral oophorectomy and loss of your ovaries. It is important to understand that although your normal training program won’t be effective anymore as it is causing these symptoms due to the stress on the body, there is a new strategy you can employ in this next chapter of your running life.

·Include three to four quality running workouts per week. Include one easy run done at a conversational effort for 40-50 minutes, one to two shorter, but harder, runs (intervals/tempo) and one endurance run. Any more than that can increase your risk for overtraining and reduce the efficiency of your recovery post workout. It’s more important to get in the quality than the quantity at this phase in your life. This will allow you to get in what you need to improve performance and reach your goals and recover post run to progress throughout the season. Plus, you’ll feel much stronger which boosts confidence, mood and motivation. If you continue to push hard day to day and push lots of miles, it will translate to decreased performance, fatigue and burnout. This is the case for most athletes over the age of 40 as well.

·Train by your body and by effort rather than pace. The body knows effort. It doesn’t know pace. It can be tempting to train by a pace, but doing so can both over or under train you for qualifying for the Boston Marathon. The key is to optimize every workout and you do that by training by how the body is feeling on every given day. For instance, your long runs should be done at a conversational, easy effort. If you go in thinking you’re going to run it at your usual or calculated 9:30 pace, but the temperature and humidity is high and running at that pace now puts you into the red or hard zone. The result is you struggle through to finish your long run and it takes five days for your body to recover, affecting all the following workouts.

You can dig yourself into a big hole when training by numbers. It appeases your mind, but isn’t effective for the body. Tune in, listen to your breath and be patient enough to train in the right zone for the workout. Your long run pace may end up being 10:30 on that hot day, but you get in the miles, stay in your easy effort and recover efficiently so you can run your interval workout a few days later.

·Run long every other week. Instead of hammering out progressive long runs week after week which can drain you, alternate a long building run with a shorter long run at a different intensity. Here is one example of a long run schedule that includes a variety of long easy runs with shorter moderate intensity runs to prepare for race pacing (this is geared towards advanced marathoners that have a base of mileage and have raced the marathon distance).

·Include total body strengthening exercises twice per week. This will help build and maintain active muscle tissue, which is vital for menopausal women to maintain weight, strength and bone density. Strengthening exercises like lunges, planks and push ups are also a great complement to developing and maintaining efficient running form. Optimal core strength will stabilize your core and reduce the risk of injuries from the demands of a high impact activity like running. If you’re in season training for a marathon or other races, avoid high intensity strength workouts as the demands of these sessions will throw off the balance of your training regimen. If you want to perform these high intensity workouts, trade a hard run for a hard run – avoid adding it into the mix as it will affect the efficiency of your recovery. In the off season when you’re not in training and running longer miles, modify your strength workouts to three times per week.

·Train no more than six days per week, sleep and go Zen. Rest is the number one way we adapt after workouts and if we’re lacking in rest, our performance suffers as you continue to train in a fatigued state. When training for your marathon, invest in at least one complete rest day. We live in cycles of sleep and awake time every day. Research supports most people need at least eight hours of quality sleep to function at an optimal rate. When we burn the candle at both ends, our hormones shift out of balance and cause havoc with our health. Olympic Marathoner Deena Kastor once told me she sleeps 10-12 hours while in season training. Put sleep at the top of your list of training strategies as it can greatly impact how you train, adapt and perform in the race. Include one calming activity day where you’re focusing on restorative yoga, easy walking or light spinning. This counter-balances the harder and longer workouts and allows your body to heal and restore mobility and focus.

·Eat well and modify carbohydrates. Runners are well known for high carbohydrate diets. However, when we shift into menopause, the lack of estrogen reduces the insulin buffering actions, resulting in weight and fat gain. The same amount of carbohydrates we ate at a younger age will induce fat at menopause. A diet lower in starches and fruits but higher in vegetables, fiber and clean protein sources will fuel your training efforts and reduce the stress on your metabolic pathways. This may seem unfair, however once you shift to eating a clean food diet, you’ll feel more energetic, recover more efficiently and perform better.

As we navigate through life’s ups and downs, it is important to continue to ebb and flow with what your body is telling you along the way. You’ve done a great job of tuning in and being aware of your performance decline, now it is time to make a few adjustments in your training and life regimen to run your best at this new phase in your life. Take your time in making these adjustments as trying to change everything all at once can be overwhelming. Ease into each change and journal about how it affects your training and energy along the way. You’ll soon find your new training recipe and it will help you reach your goals to run Boston.

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